Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis.

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  • Additional Information
    • Affiliation:
      Department of Surgery and Cancer, 4615 -->Imperial College London -->, London SW7 2AZ, UK
      West Middlesex University Hospital, Isleworth TW7 6AF, UK
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Objective: Delayed response to clinical deterioration as a result of intermittent vital sign monitoring is a cause of preventable morbidity and mortality. This review focuses on the clinical impact of multi-parameter continuous non-invasive monitoring of vital signs (CoNiM) in non-intensive care unit patients.Design: Systematic review and meta-analysis of primary studies. Embase, MEDLINE, HMIC, PsycINFO and Cochrane were searched from April 1964 to 18 June 2019 with no language restriction.Setting: The search was limited to hospitalised, non-intensive care unit adult patients who had two or more vital signs continuously monitored.Participants: All primary studies that evaluated the clinical impact of using multi-parameter CoNiM in adult hospital wards outside of the intensive care unit.Main Outcome Measures: Clinical impact of multi-parameter CoNiM.Results: This systematic review identified 14 relevant studies from 3846 search results. Five studies were classified as Group A - associations found between measured vital signs and clinical parameters. Nine studies were classified as Group B - comparison between clinical outcomes of patients with and without multi-parameter CoNiM. Vital signs data from CoNiM were found to associate with type of presenting complaint, level of renal function and incidence of major clinical events. CoNiM also assisted in diagnosis by differentiating between patients with acute heart failure, stroke and sepsis (with sub-clustering of septic patients). In the meta-analysis, patients on multi-parameter CoNiM had a 39% decrease in risk of mortality (risk ratio [RR] 0.61; 95% confidence interval [95% CI] -0.39-0.95) when compared to patients with regular intermittent monitoring. There was a trend of reduced intensive care unit transfer (RR 0.86; 95% CI -0.67-1.11) and reduced rapid response team activation (RR 0.61; 95% CI 0.26-1.43). A trend towards reduced hospital length of stay was also found using weighted mean difference (WMD -3.32 days; 95% CI -8.82-2.19 days).Conclusion: There is evidence of clinical benefit in implementing CoNiM in non-intensive care unit patients. This review supports the use of multi-parameter CoNiM outside of intensive care unit with further large-scale RCTs required to further affirm clinical impact.
    • Journal Subset:
      Biomedical; Europe; Peer Reviewed; UK & Ireland
    • Special Interest:
      Evidence-Based Practice
    • Instrumentation:
      Clinical Decision Making in Nursing Scale (CDMNS) (Jenkins)
      Impact of Events Scale (IES)
    • ISSN:
      0141-0768
    • MEDLINE Info:
      PMID: NLM32521195 NLM UID: 7802879
    • Publication Date:
      20200927
    • Publication Date:
      20200927
    • DOI:
      10.1177/0141076820925436
    • Accession Number:
      143718955
  • Citations
    • ABNT:
      SUN, L. et al. Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis. Journal of the Royal Society of Medicine, [s. l.], v. 113, n. 6, p. 217–224, 2020. DOI 10.1177/0141076820925436. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143718955. Acesso em: 30 out. 2020.
    • AMA:
      Sun L, Joshi M, Khan SN, Ashrafian H, Darzi A. Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis. Journal of the Royal Society of Medicine. 2020;113(6):217-224. doi:10.1177/0141076820925436
    • APA:
      Sun, L., Joshi, M., Khan, S. N., Ashrafian, H., & Darzi, A. (2020). Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis. Journal of the Royal Society of Medicine, 113(6), 217–224. https://doi.org/10.1177/0141076820925436
    • Chicago/Turabian: Author-Date:
      Sun, Lin, Meera Joshi, Sadia N Khan, Hutan Ashrafian, and Ara Darzi. 2020. “Clinical Impact of Multi-Parameter Continuous Non-Invasive Monitoring in Hospital Wards: A Systematic Review and Meta-Analysis.” Journal of the Royal Society of Medicine 113 (6): 217–24. doi:10.1177/0141076820925436.
    • Harvard:
      Sun, L. et al. (2020) ‘Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis’, Journal of the Royal Society of Medicine, 113(6), pp. 217–224. doi: 10.1177/0141076820925436.
    • Harvard: Australian:
      Sun, L, Joshi, M, Khan, SN, Ashrafian, H & Darzi, A 2020, ‘Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis’, Journal of the Royal Society of Medicine, vol. 113, no. 6, pp. 217–224, viewed 30 October 2020, .
    • MLA:
      Sun, Lin, et al. “Clinical Impact of Multi-Parameter Continuous Non-Invasive Monitoring in Hospital Wards: A Systematic Review and Meta-Analysis.” Journal of the Royal Society of Medicine, vol. 113, no. 6, June 2020, pp. 217–224. EBSCOhost, doi:10.1177/0141076820925436.
    • Chicago/Turabian: Humanities:
      Sun, Lin, Meera Joshi, Sadia N Khan, Hutan Ashrafian, and Ara Darzi. “Clinical Impact of Multi-Parameter Continuous Non-Invasive Monitoring in Hospital Wards: A Systematic Review and Meta-Analysis.” Journal of the Royal Society of Medicine 113, no. 6 (June 2020): 217–24. doi:10.1177/0141076820925436.
    • Vancouver/ICMJE:
      Sun L, Joshi M, Khan SN, Ashrafian H, Darzi A. Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis. Journal of the Royal Society of Medicine [Internet]. 2020 Jun [cited 2020 Oct 30];113(6):217–24. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143718955